Harrison,
Sorry, used WC for *Worker's Compensation* Forum in my post to Apache re the WC forum at
www.braintalk.org
Apache,
Things move fairly slow with Worker's Compensation, at least in comparison to what we are used to with other health insurance coverage, even HMO coverage.. this is with an attorney. Without one I'm not sure anything happens.
I wasn't assigned a Case Manager until I had already had 2 spine surgeries... and that was from a period of 1982-1992, acutually 1993 because I wasn't assigned the NCM until the surgery failed and I was asking for referral to a Pain Management Program.
I can well imagine just how your blood must be boiling with regard to the treatment your son is receiving under WC~ it's enough to drive one certifiably crazy and my personal feelings are this is part of the tactic utilized so the WC client may opt out of continuing on with the case, and settle for whatever amount of cash that would be offered, or to use other insurance or methods to take care of the problem.
Sometimes one has to do either of those things and it works out to his or her advantage. I think a few persons on this forum have gone to Europe for surgery and far benefited from surgery there vs. probably waiting around until the x amount of years for WC to approve or disapprove whatever treatment..
The "set aside" fund I mentioned is something that needs to be fully understood before undertaking when it comes to settling benefits. I'm not sure I would want to "go there" at this stage of the game with spine, however, maybe if I hadn't had any surgery done yet, or if it were a recent injury I might more readily see settling my benefits as a more viable option...
Re current authorization with my case, at this point in time, so far am authorized only for consultation with surgeon that evaluated me two years ago and said I was a candidate for multilevel ADR tho I didn't feel comfortable w/it back then so didn't go for it.. (when WC insur. co was willing to pay even tho UR denied surgery).
My Nurse Case Manager told me that after seeing the surgeon, if I'm offered the same option of two level ADR, the request still has to go thru UR for approval. I'm pretty certain that since I haven't had a discogram done in several years that would be recommended again, or at least for me to move on this, it would be.
If the request for authorization for surgery is sent in w/o that, probably a denial or request for further information will come back and most likely request for Evidence Based Medicine (or medical studies/data/literature supporting ADR vs. fusion ~ would have to show that it's the optimal choice in surgery for my case for whatever reason, and that outcome for multilevel ADR is as good if not better than outcome with multilevel fusion...
etc. ad nauseum..re my case~
Here's another website I may have already referred you to
www.workcompcentral.com
** check out becoming a member and seeing what's offered.. good for info in any/all state(s)~ esp. access to type of material if one can afford it..
Cotinued good luck with your son's endeavor with WC, may it be short and successful vs. long and drawn out..